Taste Changes in Childhood Cancer
Symptom Management, Palliative Care, or Supportive Care to relieve side-effects is an important part of cancer care and treatment and should always form part of the overall treatment plan.
Some individuals with cancer experience taste changes during or after cancer treatment. Some of the taste changes you may notice in your child include:
- The fact that some foods may taste bland to them;
- They may not be interested in eating because everything they eat tastes the same;
- Some foods may taste different to what they did before, especially sweet, salty and/or bitter foods;
- Your child may complain of a or chemical or metallic taste in the mouth, especially after eating meat or other high-protein foods
Taste changes can cause your child to dislike certain foods or refuse to eat, which will lead to weight loss, fatigue, an impaired immune system, and a lack of energy. This is not good as a child needs every ounce of strength they can get to fight the cancer and endure any cancer treatments they may be undergoing.
There are several possible causes of taste changes related to cancer and cancer treatment. Understanding the cause of your child’s problem may help you and your health care team manage these changes so that your child can eat again.
Taste changes are a common side-effect of chemotherapy treatment for cancer. Approximately 50% of people receiving chemotherapy experience taste changes. Fortunately these taste changes usually stop about 3 to 4 weeks after the treatment ends.
Various types of cancer medications can also cause taste changes, including
- Some opioid medicines, (pain medicines) such as morphine that act on the central nervous system
- Antibiotics, which are used to treat infections
Individuals who have radiation therapy to the neck and head often experience taste changes, as the radiation can damage the taste buds and salivary glands. Radiation can also cause changes to the sense of smell, which may affect how foods taste.
Taste changes caused by radiation treatment generally start to improve 3 weeks to 2 months after the treatment ends and may continue to improve for about a year. If the salivary glands are damaged by the radiation treatment, the individual’s sense of taste may not entirely return to the way it was before treatment.
Other causes of taste changes include:
- Biological therapies, such as interleukin-2 (IL-2), called aldesleukin (Proleukin)
- Damage to the nerves involved in tasting
- Dental or gum problems
- Dry mouth
- Mouth infections
- Nausea and vomiting
- Surgery to the nose, throat, or mouth
Relieving side effects is an important part of total cancer care and treatment, which is why you should discuss any symptoms your child is experiencing, new symptoms and changes in symptoms with their Oncology Team so that they can work out a regimen of palliative or supportive care for them.
While there are generally no specific treatments for changes in taste, sometimes treating the cause of the taste changes can be of some benefit. Treating causes such as dry mouth, mouth infections, or dental or gum problems can improve taste changes.
Changes in taste can make it difficult for your child to eat healthy foods and maintain their weight. If your child does not want to eat because of taste changes, you should speak to their doctor or treatment team, and possibly also a dietician.
Consider the following tips to cope with taste changes. Depending on the cause of taste changes, some tips may work better than others:
- Give your child foods that smell and taste good, even if the food is unfamiliar to them;
- Do away with cooking smells by cooking on an outdoor grill (braai), using an exhaust fan in your kitchen, or buying precooked foods. Cold or room-temperature foods also smell less;
- Give your child cold or frozen food to eat, as they may taste better than hot foods. Avoid cold foods if your child is receiving chemotherapy with Oxaliplatin (Eloxatin) as this drug makes it difficult to eat or drink anything cold;
- Give your child plastic cutlery to use and use glass cooking utensils to lessen the metallic taste;
- Give your child sugar-free gum or hard sweets with flavours like lemon, mint, or orange to help disguise any bitter or metallic taste they may have in their mouth;
- Give your child protein sources, such as chicken, eggs, fish, peanut butter, beans, or dairy products if red meats don’t taste good.
- Marinate any meat for your child in fruit juices, salad dressings, or other sauces;
- Flavour their foods with herbs, spices, sugar, lemon, or sauces;
- Avoid giving your child anything to eat for 1 to 2 hours before chemotherapy and up to 3 hours after chemotherapy. This will help prevent food distastes caused by nausea and vomiting. Avoiding giving them their favourite foods before chemotherapy may also help prevent them developing aversions to those foods;
- Get your child to rinse their mouths with a salt and baking soda solution before meals (½ teaspoon of salt and ½ teaspoon of baking soda in 1 cup of warm water), as this may help neutralise any bad tastes in their mouth;
- Encourage your child to keep a clean and healthy mouth by brushing frequently and flossing daily;
- Zinc sulphate supplements may help improve taste in your child, but make sure that you discuss this with their doctor before giving them any dietary supplements, especially during active treatment.
You can read more about Good Nutrition during cancer treatments HERE
Your Taste Changes Toolkit for During and After Cancer Treatment
In this interactive video, select the taste change you are experiencing to get specific food and lifestyle tips to help you manage them. Christy Brissette, Registered Dietitian at ELLICSR Health, Wellness and Cancer Survivorship Centre at the Princess Margaret Cancer Centre, provides practical information on what to do when food tastes too metallic, bitter, sweet or salty, or when food is bland or has no taste. Some people may also have a bad taste in their mouth when they are not eating. This video includes a recipe for baking soda mouthwash to help clean the mouth and get rid of bad tastes.
When food doesn’t taste the same, it may make you not want to eat or lower your appetite and lead to weight loss. Losing a lot of weight can make you too weak to finish your treatment and make it more difficult for you to recover after treatment. It is important to manage taste changes so that you can do your best to eat well during and after cancer treatment. If you are experiencing taste changes, tell your healthcare team.
Remember these tips to help you manage taste changes:
– If a food doesn’t taste good, try it again in a month or so
– Keep your mouth clean, especially before and after eating
–Brush your teeth and tongue
–Use rinses like flat club soda or baking soda and water
-Use your taste toolkit –If food tastes too bitter, metallic, salty or sweet use opposite flavours
–If food tastes bland or has no flavour use strong flavours
The Elephant Under the Rug: Transient Taste Changes with Cancer Therapy
It all started with a raisin.
My challenge at a recent seminar at Stanford University Hospital was to convince a room full of scientists, oncologists, nurses, and registered dietitians of the important role food plays in helping people navigate through cancer treatment. While the science is clinically relevant, I knew that we needed to reach their taste buds.
Each participant was given a raisin. They chewed and experienced the expected delicious sweetness. Then they chewed a bit of an herb, Gymnema sylvestre, which suppresses the
sensation of sweet. And then they ate another raisin. Faces puckered. I asked them, “How many people think the raisin tastes different now? How many think it tastes worse (bitter, metallic, weird)?” Eight-five “light bulbs” went off in the room.
That’s when I announced, “Welcome to your cancer patient’s mouth during chemotherapy.”
The elephant under the rug. Most doctors have never experienced what most cancer patients have: transient taste changes and total disconnect from the very food they need to help them survive and thrive through their cancer treatments. The solution? Culinary alchemy and the magic of flavor.
Enter FASS, my approach to teaching flavor through fat, acid, salt and sweet. I empower people — cancer patients, caregivers cooking for someone with cancer, and all of us getting behind the stove in our kitchen — with a little lemon, a little sea salt, a little olive oil, a little sweet — and that’s a HUGE thing! It can be life saving.
You try! Grab my quick FASS lesson, and most importantly, try it out! You’ll be amazed at how you can transform a dish that’s blah to one that sings beautifully to your tastebuds.
Read more from Rebecca Katz HERE
How to Manage Chemotherapy Symptoms Through Food | Dana-Farber Cancer Institute
Eating well during chemotherapy treatment can be a challenge. Chemotherapy can affect both appetite and flavor preference. Foods may start to taste strange or take on a metallic taste. In addition, there are many other symptoms that may affect your ability to keep yourself well-nourished. But don’t despair! Here are ways to keep your body healthy and your immune system supported during treatment.
See video HERE
For more information, recipes, and tips, and to watch more videos on Eating Well During Cancer, visit http://www.dana-farber.org/eatingwell.